Health care for transgender individuals queries: FOI release

Information requested

1 - a copy of all equality impact assessments related to any policies or strategies related to or impacting health care for transgender individuals in the last 10 years. If there are not EQIAs available for all these policies, please provide any explanations as to why it was not carried out for any policies that are available.

2 - a copy of any equality impact assessments undertaken prior to Jenni Mintos speech in response to the Cass report (published 3rd September 2024), or afterwards with relation to the implementation of the policy ideas detailed in that speech.

3 - a copy of any written advice, guidance, or instructions given to NHS boards by the Scottish Government in relation to trans healthcare following the publication of the Cass Report on 10th April 2024.

4 - a copy of any minutes where Scottish Ministers, or officials acting on their behalf, gave verbal advice, guidance, or instructions to NHS boards or staff in relation to the Cass Report published 10th April 2024.

5 - a list of any meetings where Scottish Ministers, or officials acting on their behalf, discussed trans health care with NHS boards or staff, but where minutes are unavailable.

6 - a list of organisations Scottish Ministers, or officials acting on their behalf, have engaged with to discuss the implementation or provision of trans healthcare in Scotland since the publication of the Cass Report published 10th April 2024.

Response

Regarding your first and fifth requests, while our aim is to provide information whenever possible, in this instance the costs of locating, retrieving and providing the information requested would exceed the upper cost limit of £600. This is because of the large number of documents that would be within the scope of your requests. Under section 12 of FOISA, public authorities are not required to comply with a request for information if the authority estimates that the cost of complying would exceed the upper cost limit, which is currently set at £600 by Regulations made under section 12.

You may, however, wish to consider reducing the scope of your requests in order that the costs can be brought below £600. You could, for instance, narrow the time period or policy areas you are interested in. You may also find it helpful to look at the Scottish Information Commissioner's “Tips for requesting information under FOI and the EIRs” on his website.

Regarding your second request, the Scottish Government does not have the information you have asked for, as in our searches we did not identify any Equality Impact Assessments (EQIAs) made in response to the Cass Review which pertain to policies detailed in the speech given by the Minister for Public Health and Women’s Health, Jenni Minto MSP, to Parliament on 3 September 2024. This statement announced the publication of a number of documents about gender identity healthcare, including a Transgender Care Knowledge and Skills Framework, produced by NHS Education for Scotland, and national standards for gender identity healthcare services, produced by Healthcare Improvement Scotland. Responsibility for conducting EQIAs for these documents would rest with these Health Boards.

This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested.

Following the publication of the Cass Review in April 2024, a multidisciplinary team was convened by the Chief Medical Officer for Scotland to consider the Cass Review, and to what extent its recommendations were applicable to Scotland. This multidisciplinary team published its own report in July 2024.

You may wish to note for your interests that a different type of assessment, known as a Children’s Rights and Wellbeing Assessment (CRWIA), was conducted prior to the publication of this report. This CRWIA is available here.

Regarding your third request, on 3 September 2024, the Scottish Government’s Director of Population Health wrote to Health Boards with an updated Gender Identity Healthcare Protocol. This Protocol is available on the Scottish Government’s website here. Under section 25(1) of FOISA, we do not have to give you information which is already reasonably accessible to you. If, however, you do not have internet access to obtain this information from the website listed, then please contact me again and we will send you a paper copy.

An exemption under section 30(b)(ii) applies to some of the information you have requested in your third question. Section 30(b)ii) of FOISA states that “information is exempt information if its disclosure under this Act would, or would be likely to, inhibit substantially the free and frank exchange of views for the purposes of deliberation.”

Regarding your fourth request, the Scottish Government does not have the information you have asked for, as in our searches we did not identify any minutes of meetings at which Scottish Ministers or Scottish Government officials gave verbal advice, guidance, or instructions to NHS Health Boards or staff in relation to the Cass Review. This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested.

Regarding your sixth request, the Scottish Government has engaged with a broad range of stakeholder organisations to discuss matters related to gender identity healthcare since April 2024. These organisations are as follows:

• Breast Cancer Now
• The Equality Network (including Scottish Trans)
• The Fertility Alliance
• Fertility Network UK
• Fertility Scotland National Network
• Healthcare Improvement Scotland
• LEAP Sports
• LGBT Health and Wellbeing
• LGBT Youth Scotland
• Lymphoma Action
• Mersey Care NHS Foundation Trust
• MSN Children & Young People with Cancer
• The National Gender Identity Clinical Network for Scotland
• NHS Ayrshire and Arran
• NHS Education for Scotland
• NHS Fife
• NHS Forth Valley
• NHS Grampian
• NHS Greater Glasgow and Clyde
• NHS Highland
• NHS Lothian
• NHS National Services Scotland
• NHS Tayside
• Public Health Scotland
• Scottish Lesbians
• Scottish National Blood Transfusion Service
• The Scottish Trades Union Congress (STUC) LGBT+ Workers’ Committee
• TransParentSees
• The University of Edinburgh
• The University of Glasgow

Please note that your seventh and eighth requests are being answered separately, using the case reference number 202500453403.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at https://www.gov.scot/foi-responses.